M.-Sig. One dose to be taken in milk.-Revue Intern de Médic et. Chir.-Pediatrics.

Hyoscine in the dose of 1-100 of a grain is of much value in the treatment of nocturnal emissions. Hare.

Eclampsia never occurs without several days or weeks of premonitory symptoms. It is, therefore, to be considered as a perfectly preventable disease.-Davis.

In delayed union of bones, wiring is to be preferred to any other method of treatment in use at present. The wire may later be removed.— Brinton.

In the chronic form of cystitis, it is necessary to keep the phosphates in solution by rendering the urine acid. Boracic acid and benzoic acid, in doses of 10 to 15 grains, made into pill with a little glycerin, are of the greatest value.-Hare.

Eclampsia occurring before labor may often be benefited by hypodermic injections of morphine (gr. 1-3-1-2), and also of veratrum viride (6 to 20 drops of the tincture). The veratrum viride should keep the pulse about 60 per minute.-Parvin.

The most generally useful remedy in bronchitis is an ammonium.

The following is an excellent suppository for bleeding hæmorrhoids:

In acute eczema the following wash may be used, allowing the sediment to coat over the parts:

In fibroma uteri of small size, where the removal would be associated with danger to the structure of the uterus, Prof. Montgomery advises the

use of five grains of thyroid extract three or four times daily, with a view to the absorption of the growth.

To remove comedo, or blackheads, use pressure, frequent washings with hot water and tincture of green soap, and the following stimulating lotion:

Ꭱ

Zinci sulphatis,
Potassii sulphureti

Aq. rosæ

...

aa 3 j
iv

M.-If irritation is produced discontinue the prescription for a time. Stelwagon.

When indicated, the following will be found useful as a sedative in

M.-Sign.-3 j every hour until three doses are taken.-Hare.

-College and Clinical Record.

PERMANGANATE OF POTASSIUM AS AN ANTIDOTE TO MORPHIA.

Permanganate of potassium was first recommended by Barker Smith in 1877 as an antidote to morphia, experiments having shown that when taken after a large dose of either morphia or opium it may entirely neutralize the effect of these drugs, and it is also an efficient antidote against any vegetable poisons. Numerous cases have been reported in which morphia poisoning in children had been successfully treated by internal or hypodermic administration of permanganate of potassium. In a recent number of the Klinische Wochenschrift, Dr. Vucetic has published the case of a child aged 3 years who accidentally had taken about thirty drops. of tincture of opium, and showed typical symptoms, viz., somnolence, cyanosis, contracted pupil and slow pulse. A 1 per cent. solution of permanganate of potassium was prescribed, and in the first place was injected with a Pravaz syringe into the right hypochondrium, in addition to which the child was given some teaspoonfuls of the solution. After some hours the toxic symptoms disappeared and the child eventually recovered, although it remained anæmic and showed some mental impairment. If it be considered that children up to the fifth year of age are extremely susceptible to morphia and opium, that those under four months sometimes show signs of poisoning after from two to four drops of laudanum, and that the legitimate dose of laudanum for children of from 2 to 4 years of age amounts to three and a half drops a day, it is clear that in the above case the recov

ery was due to the permanganate of potassium. The way in which the permanganate acts has not yet been cleared up, but experiments have shown that in a mixture of solutions of morphia and of permanganate of potassium the characteristic reactions of morphia are not obtainable. Only one case of poisoning with permanganate of potassium has been described; in this case, after a dose of about four ounces, death occurred from paralysis of the heart. In these cases Dr. Vucetic proposed morphia as an antidote. In morphia poisoning permanganate of potassium may be administered first hypodermically and then internally.-London Lancet.

:0:

MISCELLANEOUS.

THE ROENTGEN RAYS IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS.-Prof. Ch. Bouchard.-At the last meeting of the Academy (The Medical Week, 1896, p. 607) I called attention to the fact that pleural effusion partly arrests the Röntgen rays, resulting in the formation of a dark spot, on radioscopic examination, which is in sharp contrast with the light color of the healthy side.

Pursuing my study of the cases of pleurisy referred to in this communication, I found that the light area marking the apex of the thorax became more extensive in proportion as the effusion was absorbed. In one of the patients, however, the opacity persisted at the apex, while a light space made its appearance toward the middle of the diseased side as the effusion decreased. When finally this effusion had been almost completely absorbed, the apex still remained dark. This fact, which had not been observed in the two other cases, led me to believe that there was condensation of the pulmonary tissue at the apex of the lung on the diseased side. Percussion and auscultation showed that this was the case and revealed the existence of incipient infiltration, masked at first by the plural effusion. Radioscopy had thus been the means of detecting pulmonary tuberculosis.

I then examined a number of tuberculous patients with the aid of the fluorescent screen, invariably finding that the pulmonary lesions threw a shadow, the limits of which corresponded exactly with the data furnished by the other methods of physical examination, the intensity of the shading indicating the depth of the lesion. In two cases, light spots, delineated on the dark ground, gave evidence of the existence of cavities, which was confirmed by auscultation. In other two cases, however, in which auscultation had revealed the existence of cavities, these did not show on radioscopic examination. In one patient, in whom constitutional symptoms

and cough indicated incipient tuberculization, examination of the expectoration for the bacillus was negative, and the physical signs did not permit of arriving with certainty at the diagnosis of tuberculosis. Radioscopy showed that the apex of one lung was less permeable than the other, and a few days later all doubt was removed by the positive results of auscultation and bacteriological examination.

In diseases of the thorax, radioscopy furnishes information of equal value in every respect with that elicited by percussion. The air in the lung, through which the Röntgen rays pass, serves as a resonator for the percussion sounds. When this air is more or less completely driven out of the lung by an extravasated liquid or by morbid infiltration of the tissue, the penetrability of the thorax to the radioscopic rays decreases, resulting in greater or less obscurity, and at the same time the normal resonance decreases, being replaced by more or less complete dulness.Medical Week.

AGGLOMERATING REACTION IN TYPHOID FEVER PATIENTS DURING INFECTION AND DURING IMMUNITY.-Drs. Widal and Sicard.-A comparative study of the agglomerating reaction during infection and during immunity could not very well be undertaken in acute experimental diseases. In the animals experimented upon, in fact, the limits of these two periods are difficult to determine. Human typhoid fever, by reason of its long duration and its exact cyclical character, is better than any other disease adapted to such studies during the febrile period and during convalescence.

The fact that the agglomerating reaction makes its appearance already in the course of the infection, sometimes even on the fourth or fifth day, has now been established by ample statistical evidence. The reaction sometimes decreases, and may even disappear, as we have found in two cases, during the first week of convalescence, at a time when immunity has been fully established. It again made its appearance during the apyretic period, a few days before recurrence, in patients who consequently did not enjoy immunity. The agglomerating reaction is usually absent or considerably attenuated in individuals in whom recovery from typhoid fever dates from upward of a year, and who are immunized, inasmuch as recurrence is exceptional among them.

We have examined the serum of twenty-two persons, in whom recovery from typhoid fever dated from one to twenty-six years. In only three of these, who had had typhoid fever respectively three, seven and nine years previously, we obtained immediate, marked reaction on mixing one drop of serum with ten drops of culture. All three had suffered from a severe type of typhoid fever of long duration, with recurrence. In three

persons, in whom recovery from typhoid fever of medium severity dated from eighteen months, two and three years respectively, the reaction was slight and became perceptible only by mixing one drop of serum with five drops of culture.

Typhoid serum which agglomerates Eberth's bacillus does not appear to exert any bactericidal action on the microbe. We have kept for two months and a half, at the temperature of the laboratory, pure typhoid serums, inoculated with Eberth's bacillus, in which the agglomerations had not lost their vitality after this long time. The properties acquired by serum, frequently associated, may, therefore, sometimes be comparatively independent of each other.

Though there is yet no evidence by which to prove that the agglomerating reaction, like all changes brought about in the humors, is a means for the protection for the organism, it is probable that this is the case. If so, the clinical observations to which we have referred show that it constitutes a defensive reaction mainly during the period of infection.—The Medical Week.

SOME CLINICAL PECULIARITIES OF TYPHOID FEVER IN VERY YOUNG CHILDREN. In the Annales de la Policlinique de Bordeaux for March there is a long and comprehensive article on this subject, by Dr. Rocaz, of which the following is the substance: Having had occasion to observe cases of typhoid fever in children under five years of age, at which time, all authors agree, the disease presents an appearance which is often peculiar, the author feels justified in adding his observations to those already published, and in drawing the following conclusions:

The onset of typhoid fever in young children is more frequently sudden than in adults, and its appearance is often marked by a sudden elevation of temperature, the thermometer rising in a few hours from normal to 104° F. and more. Rillet and Barthez think this sudden onset indicates an altogether peculiar gravity of the disease.

The intestinal symptoms are generally less marked in children than in adults. There is a rather exact relation between the number and extent of the ulcerations on the one hand and the age of the patients on the other hand. The younger the children the fewer and smaller the ulcerations. Constipation is the rule during the early days of the disease; it is obstinate and does not yield sometimes until after the administration of several purgatives. When it does continue during the course of the disease, it is replaced by a slight diarrhoea which presents nothing characteristic. Hence it may be readily understood that intestinal perforation and hæmorrhage are excessively rare in very young children. Enteritis, on the contrary, is a more frequent complication in children,